Epidemiology Commons^™

Knowledge And Attitude Of Lebanese Adults Towards Asthma In Beirut, Lebanon, Farah Hatem Haidar, Doaa Issa, Maha Aboul Ela, Karim Raafat

BAU Journal - Health and Wellbeing

Asthma, a serious global health problem, has been an area of interest due to its increasing prevalence, expanding treatment costs, and rising burden on patients and the community. Since asthma cannot be cured, clinical episodes can be prevented and controlled by adequate management and sufficient knowledge of the disease. Appropriate treatment may relieve asthma symptoms and improve quality of life. However, poor knowledge of asthma disease and medication use, misdiagnoses, misuse of inhalers and inadequate self-management of disease symptoms may have a greater impact on the disease process. Therefore, assessment of the population’s knowledge and attitude toward asthma is essential. …

Hiv Preventive Care Services For Pregnant Women In Kenya Before And During The Covid-19 Pandemic, Modesta Vesonder

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly affected access to prenatal and postnatal care services for pregnant women living with HIV (PWLHIV) in counties in the Central, Eastern, and Rift Valley regions of Kenya. Many PWLHIV in some counties in Kenya faced challenges in accessing treatment services. In urban counties such as those in the Central region, HIV preventive care services were accessed with minimal disruption. Counties in the semi-arid of Eastern and Central regions experienced some disruptions in the provision of HIV preventive care services for PWLHIV. The periods under consideration were before the COVID-19 pandemic (2019) and during the COVID-19 pandemic …

Pregnancy-Related Maternal Deaths In The State Of Georgia According To Timing And Causes Of Death, Anthony Kondracki, Wei Li, Mitch Mokhtari, Bhuvaneshwari Muchandi, John A. Ashby, Jennifer L. Barkin

Georgia Public Health Association Annual Meeting & Conference

BACKGROUND: This study examines pregnancy-related maternal deaths in the State of Georgia according to timing and causes of death in association with maternal sociodemographic characteristics. METHODS: Maternal mortality data from 2016 to 2019 were obtained from the Georgia Department of Public Health and the study sample was restricted to pregnancy-related deaths. Descriptive analyses compared timing and six leading underlying causes of maternal death in association with basic sociodemographic characteristics. A distribution of the leading underlying causes of death was conducted among the four time-points, i.e., during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days …

Physical Activity In Underserved Preadolescents: Characterization Of Accumulation And Patterns, Alma I. Behar, Matthew T. Mahar, Gregory Norman, John P. Elder, Michael Pratt, Patricia Dionicio, Noe C. Crespo

International Journal of Physical Activity and Health

Objectives: The increasing rates of physical inactivity and sedentary behaviors among youth are a significant public health concern. The greatest disparities in physical activity (PA) are experienced by underserved (racial/ethnic minority, low-income) youth. This study aimed to characterize accelerometer-measured PA behaviors in a sample of low-income, predominantly Latino, preadolescents. Methods: Participants wore wrist worn GENEActiv accelerometers for 7 days. PA levels were classified as sedentary (< 50 mg), light (50-150 mg), moderate (> 150-500 mg), vigorous (> 500 mg), and MVPA (≥ 150 mg). Time spent in PA levels and sedentary time (ST), prevalence of meeting MVPA guidelines, and PA volume were estimated from accelerometer data. Three-way …

Bridging The Information Divide: Leveraging The Learning Health System To Understand Rural-Urban Health Disparities In The Covid-19 Era, Alfred J. Anzalone

Theses & Dissertations

The examination of healthcare disparities, which the COVID-19 pandemic exacerbated, revealed a pronounced divide between rural and urban settings. This divide particularly underscored the challenges of integrating rural healthcare into the Learning Health System (LHS) and utilizing real-world data (RWD) in response to a public health emergency. Our investigation expanded the growing body of literature on the rural mortality penalty, encompassing the period following the COVID-19 pandemic. By employing an LHS-enabled centralized platform of RWD, we assessed the impact of rurality on adverse COVID-19 outcomes (Aim 1), focusing on inpatient adverse events and the effectiveness of treatments and vaccinations across …

Examining The Relationship Between Patient Engagement With Digital Inhaler Technology And Asthma Control, Tanisha D. Hill

Walden Dissertations and Doctoral Studies

Asthma is a chronic lung disease that has significant public health and economic impact. Nonadherence to asthma medications can lead to poor treatment response and poor asthma outcomes. Digital health technologies have been shown to improve asthma medication adherence as well as asthma outcomes. The purpose of this quantitative research study was to examine the relationship between patient characteristics and mobile app engagement and the relationship between patient engagement with a digital inhaler app and asthma control in adult patients with uncontrolled asthma who were assigned to use a digitally enabled asthma medication and accompanying app for asthma therapy. Several …

Toxicological Impacts Of River Chemical Spills In Affected West Virginia Counties, Janice Lorraine Taylor Peters

Walden Dissertations and Doctoral Studies

Factors such as geographical location/proximity and exposure to external environmental events, as well as poor regulatory processes, are known to increase the risk for cancers among affected populations. There is still a gap in the literature related to the incidence of cancers in specific regions with heavy industrialization and environmental health hazards. In West Virginia, chemical contamination events have occurred in or near water systems. The goal of this quantitative, retrospective study was to discover whether there were any differences in the incidence of disease or adverse health effects and cancers due to chemical contamination in four counties (Kanawha, Mingo, …

Potential Adverse Cardiovascular Side Effects Following Mrna Covid-19 Vaccination, Abigayle Strohmeier

Senior Honors Theses

The COVID-19 vaccine, regarded as a triumph by some and a danger by others, has been studied due to the presence of adverse cardiovascular side effects experienced by some individuals following vaccination. Incidence and prevalence rates of these effects are examined by various demographic factors, primarily age and sex. The most prevalent adverse cardiovascular effects noted are myocarditis, pericarditis, cardiovascular disease, tachycardia, hypertension, palpitation, and acute myocardial infarction. Due to the novelty of the mRNA COVID-19 vaccine, many health studies have focused their data analysis on age or sex characteristics, however many excellent opportunities for future research are necessary to …

Case Report: Monkeypox Diagnosed In The Ed, Richard M. Baluyot, Joseph Pagano, James A. Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Rashes are one of the most common chief complaints we see as emergency medicine physicians on a day-to-day basis. Most of them tend to be self-limited and require very little workup and can be discharged home; however, it is our job to try to identify rashes that may require isolation in order to prevent an outbreak in our communities. Here we present a case of one such rash that has gained major media attention as of late, Monkeypox.

A Case Of Hhv-6 Viral Meningitis, Mohammad A. Rattu, Wayne Tamaska

Rowan-Virtua Research Day

Meningitis is the inflammation of the meninges and associated with abnormal cell count in the cerebrospinal fluid (CSF). The lack of bacterial growth in cultures, most commonly referred to as aseptic meningitis, is frequently caused by viruses [2]. Viruses have become more common as the prevalence of bacterial meningitis has decreased secondary to vaccination use, with viral meningitis being the most common form among countries. Viral meningitis will present with fever, headache, photophobia, neck stiffness and nausea and vomiting. Younger children however may not show any signs of meningeal irritation. Viral meningitis is usually self-limiting and with good prognosis; however, …

Evaluating The Epidemiological, Hormonal, And Psychosocial Sex-Based Differences In Sports-Related Concussion Outcomes, Samantha Kanny

All Dissertations

Sports-related concussions (SRCs) affect approximately 3.8 million athletes in the United States per year. A multitude of risk factors including age, sex, concussion history and prior medical conditions have been observed to significantly increase sports-related concussion symptom burden. Researchers have posited many reasons to explain sex-based differences in SRC outcomes, often categorized by biological characteristics or sociocultural factors, however, females are vastly underrepresented in sports-related concussion research, making it difficult to understand the true mechanisms underlying SRC sex-based differences. The goal of this dissertation is to help fill the current gap in knowledge on sex-based differences in sports-related concussion outcomes. …

Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick

Capstone Experience: Master of Public Health

Objective

Human Immunodeficiency Virus (HIV) infection is a global epidemic, and public health efforts are moderately effective to date. This cross-sectional study aimed to determine association between high-risk behavior (intravenous drug use, risky sexual behaviors) and odds of testing for HIV utilizing 2022 Behavioral Risk Factor Surveillance System (N= 445,132).

Methods

Using SAS 3.82, the age-stratified logistic regression model for exposure (high-risk behavior) and outcome (HIV testing) included covariates gender, race, income, mental health and checkup frequency.

Results

High-risk individuals had greater odds of testing compared to low-risk individuals (crude POR 2.98 [2.81 – 3.17]), with greatest odds observed among …

Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware

Capstone Experience: Master of Public Health

Objectives:

Examine Colorectal cancer (CRC) screening compliance among racial and ethnic groups in the United States (US) based on the US Preventive Services Task Force (USPSTF) recommendations.

Identify targeted interventions to promote screening compliance, early diagnosis, and CRC survivorship.

Methods: This cross-sectional study utilized 165,878 selected participant responses from the 2022 Behavioral Risk Factor Surveillance System. We modeled and investigated CRC screening compliance based on the USPSTF recommendations as inclusion criteria between racial/ethnic groups in the US while adjusting for covariates using a weighted stepwise logistic regression.

Results: With covariates adjustment, Hispanics (POR 1.16 95%CI 1.04-1.29), Asian …

Species Distribution And Logistic Regression Analysis Of Nosocomial Legionella Detection And Infection In New York State, 2017 – 2023, Roxann Brna

Legacy Theses & Dissertations (2009 - 2024)

Healthcare facilities are high-risk areas for legionellosis infections, as they have large, complex potable water systems ideal for Legionella proliferation, and they host susceptible populations. New York State regulation 10 NYCRR § 4-2: Protection Against Legionella in Healthcare Facilities was implemented in July 2016 to reduce healthcare-acquired legionellosis. This regulation mandated environmental surveillance of healthcare facilities’ potable water systems via culture. Data from these environmental reports were paired with data for cases of healthcare-acquired legionellosis infections for the years 2017-2023. Using these data, geographic Legionella species and serogroup distributions were described, and logistic regressions evaluated facility attributes associated with potable …

Extreme Temperature And Other Environmental Factors On Diabetes Admissions, Donghong Gao

Legacy Theses & Dissertations (2009 - 2024)

Background: Although total environmental factors have been linked with adverse health outcomes, the impacts of temperature and other total environmental factors on diabetes-related hospitalizations and emergency department (ED) visits remain inconclusive.Objective: This dissertation aims to Aim 1) test the associations between extreme heat and diabetes hospitalizations in the summer and its transitional months, identify populations vulnerable to extreme heat’s effects, and examine the modification effects of greenness on the heat-diabetes associations in warm months (Chapters 3 and 4); Aim 2) investigate the associations between extreme cold and diabetes hospitalizations in the winter and its transitional months, identify populations vulnerable to …

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience: Master of Public Health

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …

Exploring Binding Pockets In The Conformational States Of The Sars-Cov-2 Spike Trimers For The Screening Of Allosteric Inhibitors Using Molecular Simulations And Ensemble-Based Ligand Docking, Grace Gupta, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

Understanding mechanisms of allosteric regulation remains elusive for the SARS-CoV-2 spike protein, despite the increasing interest and effort in discovering allosteric inhibitors of the viral activity and interactions with the host receptor ACE2. The challenges of discovering allosteric modulators of the SARS-CoV-2 spike proteins are associated with the diversity of cryptic allosteric sites and complex molecular mechanisms that can be employed by allosteric ligands, including the alteration of the conformational equilibrium of spike protein and preferential stabilization of specific functional states. In the current study, we combine conformational dynamics analysis of distinct forms of the full-length spike protein trimers and …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

Exploring The Correlates And Predictors Of Covid-19 Vaccine Hesitancy And Uptake Among People Living With Hiv/Aids In Tennessee, Charles Olomofe

Electronic Theses and Dissertations

Background

The administration of the COVID-19 vaccines has met with resistance and hesitance from different population groups including people living with HIV/AIDS (PLWHA). It is concerning to know that PLWHAs are showing a higher rate of COVID-19 vaccine hesitancy than the general population. The objective of this study is to synthesize the literature and determine the correlates and predictors of COVID-19 vaccine hesitancy among PLWHA using primary and secondary data.

Methods

A scoping review was conducted to identify and summarize studies on COVID-19 vaccine hesitancy among PLWHA using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Extension for …

Immune Cell Pair Ratio Captured By Imaging Mass Cytometry Has Superior Predictive Value For Prognosis Of Non-Small Cell Lung Cancer Than Cell Fraction And Density, Jian-Rong Li, Chao Cheng

Faculty, Staff and Students Publications

No abstract provided.

Employing Digital Pcr For Enhanced Detection Of Perinatal Toxoplasma Gondii Infection: A Cross-Sectional Surveillance And Maternalinfant Outcomes Study In El Salvador, Mary K. Lynn, Marvin Stanley Rodriguez Aquino, Pamela Michelle Cornejo Rivas, Xiomara Miranda, David F. Torres-Romero, Hanson Cowan, Madeleine M. Meyer, Willber D. Castro-Godoy, Mufaro Kanyangarara Ph.D., Stella C.W. Self Ph.D., Ms, Berry A. Campbell, Melissa S. Nolan Ph.D., Mph

Faculty Publications

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancysafe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-andmiddle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the …

Disparities In Seasonal Influenza Immunization Between Hispanic And Non-Hispanic White Populations Within The United States: Findings From The 2022 Behavioral Risk Factor Surveillance System, Susanna Stageberg

Capstone Experience: Master of Public Health

Objective: To determine if inequities in influenza immunization exist between Hispanic and non-Hispanic White populations living in the United States.

Methods: Statistical analyses were executed to study the association between ethnicity and influenza immunization. Logistic regression was performed to determine probabilities related to vaccination. Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) was utilized.

Results: Hispanic respondents had higher odds of not being vaccinated against the flu when compared to non-Hispanic White respondents (COR = 1.82, 95% CI [1.73, 1.91]). Ethnicity, household income, education, insurance status, age, sex, preferred language, and primary care provider status …

One Year Follow Up Of A Cross-Sectional Study Of Hookworm Infection And Response To Deworming In Beposo, Ghana, Taylor Clarkson

Capstone Experience: Master of Public Health

Hookworms are soil-transmitted helminths that infect over 500 million people worldwide, primarily those in low-income countries. Infection with hookworm can cause anemia, malnutrition, and stunted physical and cognitive development. Deworming campaigns have attempted to combat hookworm infections in endemic areas for decades. However, there is growing variability in the effectiveness of deworming drugs, and post-treatment reinfections are abundant. There are significant gaps in our understanding of critical host-parasite factors that mediate hookworm infection, reinfection, and response to deworming treatment in endemic communities. A five-year prospective study was undertaken to better understand drivers of hookworm infection in rural Ghana and thus …

The Role Of Psychogenic Factors In The Etiopathogenesis Of Autoimmune Disorders In The Oral Cavity, Nadya T. Avramova, Boyko K. Bonev

Journal of Mind and Medical Sciences

Autoimmune disorders (AD) represent a heterogeneous group of multifactorial chronic conditions, which are triggered secondary to the loss of self-antigen tolerance. Their etiology involves genetic, epigenetic, and environmental factors; however, AD cannot be explained by these factors alone. Recent studies have shown increasing stress levels in industrialized countries and also increasing trends in the prevalence of autoimmune diseases. The oral mucosa is extremely responsive to emotional influences such as stress, anxiety and depression. Therefore, oral diseases can appear as a direct expression of emotions or indirectly, due to various psychological mechanisms. The aim of this study is to find and …

Determinant Of Unintended Pregnancy In Indonesia, Pika Novriani Lubis, Ratna Djuwita, Asri C. Adisasmita, Sudarto Ronoatmodjo, Maria Gayatri

Makara Journal of Health Research

Background: Unintended pregnancy is a global health problem. The number of unintended pregnancies globally is still high, accounting for 1 in 4 pregnancies. In Indonesia, it occupies 15% of total pregnancies. However, studies discussing the determinants of unintended pregnancies in Indonesia were conducted on a small scale.

Methods: This cross-sectional research utilized the data of 15,316 respondents of the 2017 Indonesia Demographic and Health Survey.

Results: The prevalence of unintended pregnancies in women with live births in the last 3–5 years was approximately 16%. The highest risk of unintended pregnancies was recorded for those with the youngest …

Maternal Care Utilization And Provision During The Covid-19 Pandemic: Voices From Minoritized Pregnant And Postpartum Women And Maternal Care Providers In Deep South, Ran Zhang, Tiffany Byrd, Shan Qiao Ph.D., Myriam E. Torres Phd, Msph, Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background

The COVID-19 pandemic has significantly affected maternal care services especially for minoritized individuals, creating challenges for both service users (i.e., African American and Hispanic pregnant/postpartum women) and maternal care providers (MCPs). Guided by a socioecological framework, this study aims to investigate the experiences of African American and Hispanic pregnant and postpartum women, as well as MCPs, in accessing and providing maternal care services during the COVID-19 pandemic in the Deep South.

Methods

We conducted semi-structured interviews with 19 African American women, 20 Hispanic women, and 9 MCPs between January and August 2022. Participants were recruited from Obstetrics and Gynecology …

Positive Epidemiology, Revisited: The Case For Centering Human Rights And Economic Justice, Farah Qureshi, Christy Denckla, Julia K. Boehm

Psychology Faculty Articles and Research

In recent years, a growing body of research in positive epidemiology has sought to expand the traditional focus of epidemiologic research beyond risk factors for disease and towards a more holistic understanding of health that includes the study of positive assets that shape well-being more broadly. While this paradigm shift holds great promise for transforming people’s lives for the better, it is also critiqued for showcasing decontextualized perspectives that could cause great harm to the public’s health if translated uncritically into population-based interventions. In this commentary, we argue for orienting positive epidemiology within a human rights and economic justice framework …

Willingness And Preferences For Long-Acting Injectable Prep Among Us Men Who Have Sex With Men: A Discrete Choice Experiment, Sam Wilson Cole, Jennifer L. Glick, Nicola B. Campoamor, Travis H. Sanchez, Supriya Sarkar, Vani Vannappagari, Alex Rinehart, Keith Rawlings, Patrick S. Sullivan, John F.P. Bridges

School of Public Health Faculty Publications

Introduction Cabotegravir long-acting injectable HIV pre-exposure prophylaxis (LA-PrEP) was shown to be safe and effective in multiple clinical trials. Increasing uptake and persistence among populations with elevated risk for HIV acquisition, especially among men who have sex with men (MSM), is critical to HIV prevention. Objective This analysis aims to understand potential users' preferences for LA-PrEP, with audience segmentation. Design Willingness to use and preferences for LA-PrEP were measured in HIV-negative, sexually active MSM in the 2020 American Men's Internet Survey. Respondents answered a discrete choice experiment with paired profiles of hypothetical LA-PrEP characteristics with an opt-out option (no LA-PrEP). …

Emerging Variants Develop Total Escape From Potent Monoclonal Antibodies Induced By Ba4/5 Infection, Chang Liu, Raksha Das, Aiste Dijokaite-Guraliuc, Daming Zhou, Alexander J Mentzer, Piyada Supasa, Muneeswaran Selvaraj, Helen M E Duyvesteyn, Thomas G Ritter, Nigel Temperton, Paul Klenerman, Susanna J Dunachie, Neil G Paterson, Mark A Williams, David R Hall, Elizabeth E Fry, Juthathip Mongkolsapaya, Jingshan Ren, David I Stuart, Gavin R Screaton

Faculty, Staff and Student Publications

The rapid evolution of SARS-CoV-2 is driven in part by a need to evade the antibody response in the face of high levels of immunity. Here, we isolate spike (S) binding monoclonal antibodies (mAbs) from vaccinees who suffered vaccine break-through infections with Omicron sub lineages BA.4 or BA.5. Twenty eight potent antibodies are isolated and characterised functionally, and in some cases structurally. Since the emergence of BA.4/5, SARS-CoV-2 has continued to accrue mutations in the S protein, to understand this we characterize neutralization of a large panel of variants and demonstrate a steady attrition of neutralization by the panel of …